TITLE: Genotypes of hepatitis C virus: their
relationship with risk factors, the severity of liver disease, and
the serologic response

Abstract:
BACKGROUND: The objective of our study was to ascertain the
prevalence of different HCV genotypes between the hepatitis C
patients in the health area of Monforte de Lemos, Spain, as well as
the possible influence of risk factors on their distribution and
their relation with hepatic disease and with the serologic
response.

PATIENTS AND METHODS: We have studied 128 patients with
hepatitis C. Of these, 41 were intravenous drug users (IVDU), 19
had received transfusions, 7 were hemodialyzed and in 61 the risk
factors were unknown. Antibodies against HCV were detected by
second-generation enzyme immunoassay (EIA) and confirmed by
immunoblot. RNA-HCV presence was studied by reverse
transcription-PCR (RT-PCR), and a reverse hybridization test of the
amplifications was used for the genotyping.

RESULTS: Hepatitis C genotypes Ib (46.1 [8.6%]), la (23.4
[7.3%]) and 3a (13.3 [5.9%]) were the most frequently encountered
genotype. Genotype la (48.8 [15.3%]) was the most prevalent
genotypes in IVDU patients, while Ib was the most frequent in
patients of unknown risk factors (62.3 [12.1%]),
Alanine-aminotransferase (ALT) was elevated in 66.6 (17.7%) of
patients with genotype la, in 87.5 (8.6%) of patients with genotype
Ib (p = 0.0367) and in 94.1 (11.2%) of patients with genotype 3a (p
= 0.0347). Subtype Ib was present in 6 of 7 cases of cirrhosis
(85.7%) and in 7 of 12 cases of active chronic hepatitis (58.3%).
No significant statistical differences were observed between the
genotypes and the specific IgM response against core antigen of
HCV, neither we observed differences in the serologic response
against C1, C2, NS3 and NS4 peptides,

CONCLUSIONS: Hepatitis C genotypes la and 3a were the most
prevalent genotypes between IVDU patiens while genotype Ib was the
most frequent between non-IVDU patients. Genotype Ib was associated
to severe liver disease. Percentage of positivity or the reactivity
against HCV peptides was independent of the genotype encountered in
the patient.